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AND   SURGEONS 


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TEN 

YEARS' 

EXAMINATIONS. 

A  Complete  Set  of  all  of  the  Written  Examination 
Questions  given  in  the 

College  of  Physicians  and  Surgeons, 

IN  THE  CITY  OF  NEW  YORK. 

Medical  Department  of  Columbia  College. 
1880-1891. 


H.   P.  de  FOREST,   M.  D. 

Methodist  Episcopal  Hospital,  Brooklyn, 

Editoe. 


■lc*t 


V\Yl 


/ 


PART  I. 


^N ATOMY  and^URGERY. 


ANATOMY. 

Fall,  187S. 

1.  Describe  the  radius. 

2.  What  muscles  pass  from  leg  to  foot  and  toes? 

3.  Branches  of  internal  carotid  artery  and  their  branches? 
i.  Differences  between  duodenum  and  ileum  ? 


Spring.  1880. 

1.  Describe  the  first  rib  and  its  relations. 

2.  What  muscles  flex,  and  what  extend  the  phalanges  of  the  fingers  ; 
give  action  of  each  muscle  or  group  of  muscles? 

3.  What  are  the  motor  and  what  the  sensory  nerves  of  the  larynx. 

4.  Of  what  are  they  branches  ?     What  muscles  do  the  motor  nerves 
supply  ? 

5.  What  veins  form  the  venae  portae. 

Fall..  1880. 

1.  Bones  forming  roof,  floor,  outer  and  inner  walls  of  the  nasal  fossa. 

2.  Action  of  the  psoas,  iliacus,  and  the  three  glutei? 

3.  Course,  relations  and  branches  of  the  radial  artery  ? 

■i.     Muscular  and  cutaneous  distribution  of  median,  ulnar,  and  musculo- 
spiral  nerves. 

.I.     What  do  you  understand  by  Glisson's  capsule? 


Spring,  1881. 

1.     Give  as  fully  as  possible,  origins,  insertions  and  actions  of  : — 

(a).     Pronator  radii  teres. 

(6).     So-called  supinator  longus. 


2.  What  movements  are  possible  when  knee-joint  is  semiflexed'? 

3.  Enumerate  the  muscles  which  cross  the  knee-joint,  and  name  the 
nerves  by  which  each  is  supplied. 

4.  Which  ventricle  of  the  brain  has  no  opening  connecting  it  with  any 
of  the  others?    State  where  in  the  brain  this  is  situated? 

5.  State  at  what  point  of  the  chest  wall  the  lower  margin  of  the  right 
lung  usually  lies  in  the  neigborhood  of  the  mammary  line,  and  at  what 
point  in  the  neighborhood  of  the  scapula  ? 

6.  Are  the  tendinous  cords  which  stretch  from  either  of  the  two 
papillary  muscles  of  the  mitral  valve  attached  to  one  curtain  only  or  to 
both  ?  What  is  the  mechanical  value  of  the  arrangement  you  describe  in 
the  above  question  ? 

7.  What  important  artery  of  the  front  of  the  forearm  lies  at  one  part 
of  its  course  behind  the  pronator  radii  teres  ? 

8.  Enumerate  the  venous  vessels  through  which  a  blood  corpuscle 
would  pass  in  succession  before  reaching  the  right  auricle  of  the  heart, 
starting  from  the  wall  of  the  jejunum? 

9.  State  at  what  anatomical  point  you  would  open  the  air  passages  in 
case  of  so-called  oedema  of  the  glottis,  and  upon  what  anatomical  grounds 
would  your  choice  be  made  ? 

Kail,  1881. 

1.  Describe  the  lower  end  of  humerus. 

2.  Actions  of  peroneous  longus  and  brevis  ? 

3.  Define  and  locate  the  island  of  Eeil. 

4.  Arteries  of  the  brain,  origin  of  each,  Circle  of  Willis,  and  what 
compose  it? 

5.  Anatomy  of  villus  of  small  gut. 

6.  Anatomical  arrangements  rendering  colotomy  practicable  ;  principal 
anatomical  danger  ;  to  what  muscle  is  the  large  gut  in  specially  close  rela- 
tion when  we  open  the  latter  ? 

7.  Locate  cardiac  semilunar  valves,  and  describe  them  and  their 
mechanism. 

8.  What  parts  make  up  the  root  of  the  lung  ? 

9.  What  is  the  trigonum  vesicae  ? 

10.  What  important  fascia  will  be  pierced  in  lateral  lithotomy  if  knife 
should  cut  entirely  through  base  of  prostate  gland.  What  tissue  imme- 
diately overlies  the  tissue  in  question  ? 


1. 


Spring,  1882. 

What  bones  articulate  with  the  superior  maxilla  ? 


2.     What  is  the  action  of  the  peroneus  longus  ? 


3.  What  muscles  would  be  paralyzed  bjr  section  of  spinal  accessory 
nerve  within  the  skull  ? 

4.  Name  all  the  parts  which  would  be  divided  if  forearm  were  com- 
pletely severed  midway  between  the  wrist  and  elbow? 

5.  Describe  velum  interpositum,  septum  lucidum  and  foruix. 
G.     Give  difference  between  right  and  left  bronchus. 

Fall,  1882 

1.  Anatomy  of  the  knee-joint? 

2.  What  forms  the  circle  of  Willis? 

3.  Contents  of  the  orbit ;  gross  anatomy  of  the  eye? 
4  What  do  you  see  in  cut  section  of  kidney? 

5.     What  parts  are  cut  in  lateral,  and  what  in  median  lithotomy? 


Spring,  1883. 

1.  Describe  inferior  maxilla  and  give  relations. 

2.  Name  the  muscles  which  pass  from  the  pelvis  and  vertebrae  to  the 
femur,  and  give  the  action  of  each. 

3.  Relations  of  left  subclavian  artery. 

4.  Distribution  of  the  median,  ulnar  and  musculo-spiral  nerves  to  the 
muscles  of  the  forearm  and  hand,  and  the  cutaneous  distribution  of  the 
hand  ? 

5;  Gross  Anatomy  of  the  stomach,  relations  to  the  neighboring  organs 
and  to  the  abdomen  and  chest  walls/ 

tj.     Difference  between  the  sinus  and  the  pelvis  of  the  kidney? 

Fall,  1883. 

1.  Knee-joint  and  its  movements? 

2.  Relations  and  branches  of  the  abdominal  aorta? 

3.  What  parts  are  divided  in  amputation  at  shoulder-joint? 

4.  Describe  the  membranes  of  the  brain  and  spinal  cord. 


Spring,  1884. 

1.  Anatomy  of  the  elbow-joint ;  actions  and  relations. 

2.  Serratus  magnus,  origin,  insertion,  innervation  and  action. 

3.  Formation  and  relation  of  palmar  arches  and  branches. 

4.  Relations  of  the  spleen  and  kidneys. 

5.  Formation  and  branches  of  the  brachial  plexus. 


Fall,  1884. 

1.  Describe  the  hip-joint  and  the  upper  extremity  of  the  femur? 

2.  Name  internal  and  external  rotators  of  the  thigh  ? 

3.  Course  relation  and  branches  of  femoral  artery? 

4.  Name  the  jugular  veins  and  what  arteries  they  accompany,  if  any? 

5.  Boundaries  of  the  inguinal  canal,  and  the  relations  of  the  deep 
epigastric  artery  to  it  ? 


Spring,  .        1885. 

1.  Describe  the  outer  wall  of  the  nasal  fossa. 

2.  Give  the   anatomy  of   the   movements  of  the   temporo-maxillary 
articulation. 

3.  Describe  the  great  sciatic  nerve  and  its  branches. 

4.  Relations  of  the  axillary  artery. 

5.  Anatomy  of  the  rectum  ? 

Fall,  1885. 

1.  Describe  the  frontal  bone. 

2.  Describe  the  trapezius  muscle. 

3.  Describe  the  ankle-joint. 

4.  Describe  the  gustatory  nerve. 

5.  Relations  of  the  spleen. 

6.  Relations  of  popliteal  artery. 


Spring,  1886. 

1.  Describe  the  astragalus. 

2.  Inferior  maxillary  nerve  ? 

3.  Describe  the  arch  of  the  aorta  and  give  its  relations. 

4.  Describe  the  fornix. 

5.  What  muscles  abduct  the  arm,  and  what  movements  take  place 

Kail,  1886. 

1.  Describe  the  orbit — its  bones,  fissures  and  foramina. 

2.  Describe  the  popliteal  space  and  its  contents. 

3.  Explain  the  movements  of  the  rotation  of  the  forearm—  (a).   When 
flexed  ;  (6).  When  extended. 

4.  Relation  of  liver  to  abdominal  walls  and  thorax. 

5.  Describe  right  auricle  of  the  heart. 

6.  Give  anatomy  of  ligature  of  the  third  part  of  subclavian  artery. 


Spring,  1887. 

1.  Describe  the  occipital  bone. 

2.  Describe  the  ankle-joint. 

3.  Describe  the  lingual  artery  and  its  branches. 

4.  Describe  the  nerve  supply  of  the  muscles  of  the  forearm. 

5.  Describe  the  relations  of  the  stomach. 

6.  Describe  the  relations  of  the  left  ureter. 

F^all,  1887. 

1 .  Describe  the  three  fossa;  at  the  base  of  the  skull,  their  foramina, 
and  the  nerves  they  transmit. 

2.  Describe  the  tibialis  posticus  ;  its  origin,  insertion,  nerve  supply 
and  action. 

3.  Describe  the  relations,  branches  and  anastomoses  of  the  submax- 
illary artery. 

i.     Describe  the  relations  of  the  stomach. 

5.  What  structures  would  be  cut  by  a  section  midway  between  the 
knee  aud  ankle  V  (Circular  amputation). 

Spring,  1888. 

1.  Describe  the  hip-joint  and  the  upper  extremity  of  the  femur. 

2.  Mention  the  muscles  in  relation  with  the  elbow-joint;  their  actions 
and  nerve  supply? 

3.  Describe  the  anatomy  of  the  ligature  of  the  third  part  of  the  sub- 
clavian artery. 

1.     Describe  the  mucus  membrane  of  the  intestine. 

FalL  1888. 

1.  Give  the  position,  structure  and  relation  of  the  caput  coli  and 
appendix  ;  as  well  as  the  reflection  of  the  peritoneal  coat. 

2.  Describe  the  tempero  maxillary  articulation,  its  anatomy,  ligaments 
and  relations  ;  the  muscles  which  produce  the  various  motions  and  their 
nerve  supply. 

3.  How  many  jugular  veins  are  there  V     Describe  them  ? 

4.  Give  the  relations  of  the  spleen  and  kidney. 


Spring,  1889. 

1.  Describe  the  knee-joint. 

2.  Describe  the  position  and  relations  of  structures  surrounding  knee- 
joint. 

3.  Nerve  supply  of  muscles  of  forearm  and  hand. 


4.  Describe   the  caecum  and  appendix  vermiformis.      Give  position 
and  relations. 

5.  Relations  of  the  Duodenum. 


Kail,  1889. 

1.  Describe  temporo-maxillary  articulation. 

2.  Origin,  insertion,  nerve  supply  and  action  of  serratus  magnus. 

3.  Nerve  supply  of  tibialis  anticus,  brachialis  anticus,  and  supinator 
longus. 

4.  Course  and  relation  of  the  superficial  palmar  arch. 

5.  Eelations  of  spleen. 


Spring,  1890. 

1.  Mention  in  order  the  articulations  of  the  trapezium  ;  of  the  malar. 

2.  Describe  joint  surfaces  and  mechanism  of  atlo-axoid  joint. 

3.  Accessory  ligaments  of  astragalus  and  os  cnlcis. 

4.  Ligaments  checking  abduction  and  outward  rotation   of  the  hip- 
joint. 

5.  Enumerate  in  order  the  extensor  tendons  passing  over  the  wrist- 
'joint,  and  usual  arrangement  of  their  sheaths. 

6.  Muscles  supplied  by  externalplantar  nerve. 

7.  Articular  nerves  to  elbow-joint. 

8.  Usual  cutaneous  supply  to  ring  finger. 

9.  Relations  of  posterior  interosseous  artery. 

10.  Origin,  insertion  and  action  of  trapezius. 

11.  Relations  of  left  kidney. 

12.  Trace  projection  on  thoracic  wall  of  costal  portion  of  interlobular 
incisons  of  right  and  left  lung. 

13.  Relative  positions  of  columns  of  medulla. 

14.  Position  of  lingula  ;  of  funiculus  teres. 


Fall,  18QO. 

1.  Give  the  relations  of  the  second  portion  of  the  axillary  artery. 

2.  Describe  the  Duodenum,  and  give  the  relations  of  the  various  parts. 

3.  Describe  in  full  the  gluteus  maximus. 

4.  What  is  the  innervation  of  the  latissimus  dorsi? 

5.  Give  the  nerve  supply  of  the  muscles  of  the  forearm. 

6.  "What  structures  form  the  roof  of  the  fourth  ventricle  ? 

7.  Give  the  articulations,  in  order,  of  the  superior  maxillary  bone. 


(MARKS'  PATENTS.) 


WITH  EUBBEE  HANKS  AND  FEET. 


Thirty-Eight  Years  of 

the  most  extensive  experience, 
with  the  most  satisfactory  re- 
sults of  any  manufacturer  in 
the  world.  The  confidence  of 
the  public,  popularity  among 
the  crippled,  and  flattering 
commendations  from  all  parts 
of  the  world,  attest  the  supe-  | 
riority  of  the 

ROBBER  HAND  AND  FOOT, 

which  possess  the  quality  of 
yielding  to  every  essential 
angle  of  the  natural,  without 
the  use  of  complicated  hinges, 
joints  and  contrivances  which 
only  annoy  and  render  expensive  their  daily  use.  The  accom- 
panying cut  represents  a  young  man  who  lost  both  legs  by  a 
railroad  accident,  one  above  the  knee  and  the  other  two 
inches  below. 

He  is  able  to  walk  One-Half  Mile  in  Eight  Minutes, 

without  a  cane  or  any  assistance,  except  his  artificial  limbs  with  rubber 
feet.  He  can  perforin  a  day's  work  without  unusual  fatigue,  can  go  up 
and  down  stairs ;  in  fact,  can  do  any  of  the  ordinaries  of  life  without 
exhibiting  his  loss. 

Parties  who  live  at  a  distance,  or  who  would  be  inconvenienced  by  a 
journey  to  our  place,  can  supply  measurements  on  our  Copyright  Formula, 
and  feel  the  assurance  that  they  will  receive  our  best  attention.  Thousands 
are  thus  treated  in  Canada,  Mexico,  Central  and  South  America,  Europe, 
and  our  own  States  and  Territories. 

A  Treatise  of  400  pages,  with  200  illustrations  and  Copyright  Formula, 
sent  free. 

U.S.  GOVERNMENT   MANUFACTURER. 


A.  A.  MARKS.  TO!  Broadway,  3$ew  York  City. 


11 


SURGERY. 


Fall,  1879. 

1 .  Principal  agents  controlling  inflammation. 

2.  Points  of  distinction  between  fracture  and  dislocation. 

3.  Pathology  and  treatment  of  penetrating  wounds  of  the  chest. 

4.  Differential  diagnosis  of  popliteal  aneurism. 

5.  Describe  lateral  lithotomy. 


Spring,  1880. 

1.  Causes  of  mortification. 

2.  Symptoms  of  traumatic  meningitis. 

3.  Means  for  arresting  venous  hemorrhage. 

4.  Pathology  and  treatment  of  intussusseption. 

5.  Ligature  of  femoral  artery:   Describe  the  operation. 

Kail,  1880. 

1.  Signs  of  abscess.     Treatment  of  acute  and  chronic  abscess. 

2.  Diagnosis  and  treatment  of  fractures  of  the  lower  end  of  the  radius. 

3.  Peculiarities  of  gun-shot  wounds. 

4.  Indications  for  tracheotomy,  and  methods  for  performing  it. 

5.  Diagnosis  of  internal  and  external  hemorrhoids, 
(i.  What  is  ' l hare  lip ?" 


Spring.  1881. 

1.  Give  the  clinical  history,  the  pathological  anatomy,  the  diagnosis, 
the  prognosis  of  a  case  of  chronic  strumous  arthritis  of  the  knee  joint, 
with  the  treatment  of  each  stage. 

2.  State  the  symptoms,  the  diagnosis  and  the  treatment  of  penetrating 
wounds  of  the  chest. 

3.  Describe  the  several  varieties  of  strangulated  inguinal  hernia. 

Kail,  1881. 

1.  Give  the  causes,  varieties,  symptoms  and  results  of  mortification, 
and  the  treatment  of  each  form  and  stage. 

2.  Give  the  treatment  of  surgical  or  external  aneurism.  State  the 
indications  or  contra-indications  for  each  method. 


12 

Spring,  18812. 

1.  Contrast   the   pathological   features   of  primary  caries   with   acute 
necrosis. 

2.  What  are  the  rales  of  treatment  in  wounds  of  uterus? 

8.     In  what  case3  is  laryngotomy  preferable  to  tracheotomy  ? 

4.  Describe   the   several   varieties   of    malformations  of   rectum   and 
auus. 

5.  What  is  the  character  of  the  urine  in  neuroses  of  the  male  genito- 
urinary organs  ? 

Fall,  1882. 

1,  Give  the  varieties,  symptoms  and  treatment  of  injuries  of  the  skull. 

2,  Give  the  morbid  anatomy  and  treatineut  of  internal  hemorrhoids. 
State  when  and  how  lumbar  colotomy  should  be  performed. 
What  are  the  causes  of  retention  of  urine  ? 
Give  the  diagnosis  of  intussusseption. 


Spring,  1883. 

1.  Seat,    diagnosis  and   treatment  of   fractures  of   lower  end  of   the 
humerus. 

2.  Causes  of  mortification. 

3.  What  is  hydrocephalus  ? 

4.  Describe  the  operations  of  lumbar  colotomy. 

5.  What  are  the  several  operations  for  hydrocele  ? 

G.     Pathology  and  diagnosis  of  turnors  of  urinary  bladder. 

Fall,  1883. 

1.  Clinical   history,    symptoms,    diagnosis   of   psoas  abscess,   and  the 
treatment. 

2.  Diagnosis  of  fracture  of  neck  of  the  femur. 

3.  Treatment  of  popliteal  aneurism. 


Spring,  1884. 

1.  What  is  the  mechanism  of  traumatic  emphysema  ? 

2.  Describe  and  differentiate  the  several  varieties  of  lymphoma  of  the 
neck  ? 

?>.     Causes,  morbid  anatomy  and  treatment  of  internal  hemorrhoids? 

4.  Causes,  symptoms,  pathological  changes,  and  termination  of  stru- 
mous arthritis. 

5.  Diagnosis  of  fracture  of  the  neck  of  the  femur. 


Kail,  1884. 

1.  Pathology,  clinical  history  and  treatment  of  acute  abscess? 

2.  Mode  of  treatment  of  popliteal  aneurism. 

3.  Diagnosis  of  fracture  of  cervix  femoris. 


Spring,  1885. 

1.  Pressure  effects  of  bronchocele  ? 

2.  Symptoms  and  diagnosis  of  sacculated  aneurism '? 

3.  Operation  for  harelip  ? 

4:.     Histological  difference  between  sarcoma  and  carcinoma  ? 
5.     Fracture  and  dislocations  of  the  clavicle  ? 

Fall,  1885. 

1 .  Acute  caries  of  the  tibia :  pathological  conditions,  symptoms,  diag- 
nosis and  treatment ? 

2.  Acute  intestinal  obstruction,  its  medical  and  surgical  treatment? 


Spring,  1886. 

1.  Diagnosis  and  treatment  of  tubercular  disease  of  the  joints? 

2.  When  should  the  external  carotid  artery  be  tied  in  preference  to  the 
common  carotid,  and  what  are  the  steps  in  the  operation  ? 

3.  State  the  causes,  symptoms,  prognosis,  and  treatment  of  erysipelas. 

4.  Describe  the  causes  and  treatment  of  intestinal  obstruction. 

Fall,  1886. 

1.  Causes,  symptoms,  and  treatment  of  erysipelas? 

2.  Describe  diagnosis  and  treatment  of  wounds  of  the  intestine. 

3.  Describe  the  dislocations  at  the  elbow  joint. 


Spring,  1887. 

1.  Symptoms,  pathological  anatomy  and  treatment  of  necrosis  of  the 
shaft  of  the  tibia. 

2.  Give  the  symptoms  and   course  of   acute   pyasmia,    and  of   acute 
septicaemia. 

3.  State  the  chief  indications  for  primary  amputation  in  the  case  of 
compound  fracture  of  the  fibula,  seen  immediately  after  injury. 

■i.     Describe  the  method  of  performing  lateral  lithotomy. 

5.  Stricture  of  oesophagus ;  symptoms,  diagnosis,  and  treatment. 

6.  Medical  and  surgical  treatment  of  perityphlitis. 


14 

Fall,  1887. 

1.  Treatment  of  surgical  diseases  of  the  gall  bladder. 

2.  Diagnosis  of  the  fracture  of  cervix  f emoris. 

3.  Describe  an  antiseptic  dressing. 


Spring,  1888. 

1.  Delirium  Tremens;  causes,  symptoms,  diagnosis  and  treatment? 

2.  Diagnosis  of  sub-cranial  extravasation  of  blood. 

8,     Causes  and  symptoms  of  acute  intestinal  obstruction. 

4.     Describe  the  malformations  of  anus  and  rectum. 

r>.     Describe  the  method  for  circular  amputation  of  the  thigh. 

Kail,  1888. 

1.  Indications  for  trephining. 

(a).     In  injuries. 
{/>.)     In  diseases. 

2.  Treatment  of  hernia  by  radical  methods. 

3.  Diagnosis  of  fracture  of  cervix  femoris  ? 


Spring,  1889. 

1.  Give  the  pathological  and  clinical  history  of  a  case  of  acute  necrosis 
of  tibia. 

2.  Give  the  causes,  symptoms,  and  the  treatment  of  fracture  of  the 
head  of  the  humerus. 

'.).  What  are  the  dangers  to  life  from  harelip  and  cleft  palate  ?  What 
is  the  most  favorable  time  for  operation  ? 

-t.     Symptoms  and  diagnosis  of  stricture  of  the  oesophagus  ? 

.">.     Name  the  benign  tumors  of  female  breasts. 

f>.  Mention  those  features  of  a  neoplasm  in  the  female  breast  which 
would  make  probable  a  diagnosis  of  carcinoma. 

7.  The  symptoms  of  fissure  of  the  anus  ? 

8.  What  are  the  indications  for  the  operation  of  excision  of  joints  ? 

Fall,  '  1889. 

1.  Give  the  clinical  features  of  an  attack  of  inflammatory  external 
hemorrhoids,  and  the  treatment. 

2.  Symptoms  of  renal  calculus  ? 

3.  Causes  of  non-union  after  simple  fracture  ? 


15 

4.  Sequestrum  of  shaft  of  long  bone. 

5.  After  injury  to  trunk  or  abdomen  what  symptoms  indicate  intra- 
peritoneal rupture  of  the  bladder? 

(>.     Describe  antiseptic  precautions  in  amputation. 

7.  In  what  regions  are  antiseptic  solutions  dangerous. 

8.  Describe  appearances  of  wounds  of  soft  parts,  which  become  septic 
from  any  cause.     What  are  the  constitutional  effects  that  accompany  this  ? 

!).     Mention  the  different  forms  of  syphilis  of  the  tongue. 


Spring,  1800. 

1.  State  the  different  methods  of  controlling  surgical  hemorrhage. 

2.  Mention  the  signs  of  fracture  of  the  cervix  femoris,  and  state  how 
they  differ  from  those  of  a  dorsal  dislocation  of  the  head  of  the  femur. 

3.  Give  the  symptoms  and  treatment  of  a  case  of  severe  traumatic 
shock. 

4.  The  differential  diagnosis  of  a  case  of  acute  intestinal  obstruction 
and  peritonitis. 

5.  Upon  what  clinical  features  would  you  base  a  diagnosis  of  a  rupture 
of  the  membranous  urethra? 

6.  What  are  the  indications  for  the  operation  of  nephrotomy  and 
nephrolithotomy?  The  method  of  performing  each  operation.  (Omit 
antiseptic  details). 

Fall,  1890. 

1.  Under  what  circumstances  does  the  accident  known  as  entrance  of 
air  into  the  veins  occur?     What  are  its  symptoms,  treatment,  and  result? 

2.  Describe  a  typical  case  of  Pott's  fracture,  and  the  treatment. 

3.  The  symptoms,  course,  and  treatment  of  ischio-rectal  abscess. 

4.  Describe  the  clinical  features  of  cancer  of  the  tongue. 

5.  The  differential  diagnosis  between  inguinal  Lernia  and  varicocele  ? 


COLUMBIA   UNIVERSITY 

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expiration  of  a  definite  period  after  the  date  of  borrowing, 
as  provided  by  the  rules  of  the  Library  or  by  special  ar- 
rangement with  the  Librarian  in  charge. 


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J  C72 
•sity.   C0llegell89l, 
\d   surgeons     1 


